A Nomogram for Predicting Cancer-Specific Survival of Osteosarcoma and Ewing's Sarcoma in Children: A SEER Database Analysis.

Jinkui Wang,Xiaojun Tan,Jiayan Liu,Dawei He,Zhaoxia Zhang,Tao Mi,Chenghao Zhanghuang,Liming Jin,Mujie Li

doi:10.3389/fpubh.2022.837506

Abstract

BackgroundOsteosarcoma (OSC) and Ewing's sarcoma (EWS) are children's most common primary bone tumors. The purpose of the study is to develop and validate a new nomogram to predict the cancer-specific survival (CSS) of childhood OSC and EWS.MethodsThe clinicopathological information of all children with OSC and EWS from 2004 to 2018 was downloaded from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analyses were used to screen children's independent risk factors for CSS. These risk factors were used to construct a nomogram to predict the CSS of children with OSC and EWS. A series of validation methods, including calibration plots, consistency index (C-index), and area under the receiver operating characteristic curve (AUC), were used to validate the accuracy and reliability of the prediction model. Decision curve analysis (DCA) was used to validate the clinical application efficacy of predictive models. All patients were divided into low- and high-risk groups based on the nomogram score. Kaplan-Meier curve and log-rank test were used to compare survival differences between the two groups.ResultsA total of 2059 children with OSC and EWS were included. All patients were randomly divided into training cohort 60% (N = 1215) and validation cohort 40% (N = 844). Univariate and multivariate analysis suggested that age, surgery, stage, primary site, tumor size, and histological type were independent risk factors. Nomograms were established based on these factors to predict 3-, 5-, and 8-years CSS of children with OSC and EWS. The calibration plots showed that the predicted value was highly consistent with the actual value. In the training cohort and validation cohort, the C-index was 0.729 (0.702–0.756) and 0.735 (0.702–0.768), respectively. The AUC of the training cohort and the validation cohort also showed similar results. The DCA showed that the nomogram had good clinical value.ConclusionWe constructed a new nomogram to predict the CSS of OSC and EWS in children. This predictive model has good accuracy and reliability and can help doctors and patients develop clinical strategies.

Highlights

Osteosarcoma (OSC) and Ewing sarcoma (EWS) are the most common primary malignant bone tumors in children and young people [1,2,3]
A total of 2,059 children with OSC and EWS were included in our study
Children whose primary tumors were located in limb, cranial, spine, thoracic and pelvic were 1,576 cases (76.5%), 93 cases (4.52%), 56 cases (2.72%), 118 cases (5.73%), and 216 cases (10.5%), respectively

Summary

Introduction

Osteosarcoma (OSC) and Ewing sarcoma (EWS) are the most common primary malignant bone tumors in children and young people [1,2,3]. Various treatments are used to improve the prognosis, the survival rate of OSC is still shallow [5,6,7], the 5-year survival rate of patients with localized OSC can reach 65–70% [8]. The survival rate of patients with metastatic OSC is only 19–30% [9, 10]. With the improvement of treatment technology, the 5-year survival rate of EWS has reached 60% to 70%, but the prognosis of patients with metastasis and recurrence is still poor [11]. Osteosarcoma (OSC) and Ewing’s sarcoma (EWS) are children’s most common primary bone tumors. The purpose of the study is to develop and validate a new nomogram to predict the cancer-specific survival (CSS) of childhood OSC and EWS

Objectives

Methods

Results

Discussion

Conclusion